Nursing Diagnoses

Since Polycystic Kidney Disease is a chronic disease that people will live with for many years, it is helpful to the nurse to recognize common nursing diagnoses for this disease and treat them early, along with good maintenance and upkeep. This will help to ensure the best quality of life for people living with chronic kidney diseases.

The top five nursing diagnoses for Polycystic Kidney Disease:

1) Risk for infection r/t altered organ functioning

2) Ineffective coping r/t depression resulting from chronic disease

3) Impaired urinary elimination r/t effects of disease

4) Impaired comfort r/t headache, back pain, pain with urination

5) Noncompliance r/t complex medical therapy

Today we will focus on how to handle impaired urinary elimination.

Impaired urinary elimination is related to blood in the urine, pain while urinating, urinary tract infection, frequent urination, urge to urinate with no production, and urination during the night.

Target Outcomes for the patient include demonstrating diurnal frequency no more than every two hours, demonstrate nocturia two times or less per night, be able to postpone voiding until toileting facility is accessed and clothing removed,  be able to perceive and recognize cues for toileting, move to toilet or use urinal or portable toileting apparatus, and remove clothing as necessary for toileting, demonstrate postvoiding residual volumes less than 150 mL to 200 mL or 25% of total bladder capacity, and state absence of pain or excessive urgency during bladder storage or during urination.

Evidence-based Nursing Interventions include routine screening for urinary incontinence or bothersome urgency, teach patient signs and symptoms of urinary tract infection, complete a detailed bladder log with patients, teach elimination of potential bladder irritants (caffeine, alcohol, aspartame, carbonated beverages, citrus juices, chocolate, vinegar, and highly spiced foods), education about reducing constipation through intake of fiber and exercise (fluids will be monitored), education regarding smoking cessation, consult physician when signs of urinary tract infection are present, refer individual to pelvic specialist to manage pain, teach patients that cloudy or malodorous urine in the absence of other symptoms does not likely mean a urinary tract infection, teach the patient to recognize hematuria and promptly seek help if hematuria occurs, assist the patient to select adequate products to deal with urinary leakage, and teach proper perineal care.

This information was obtained from OvidSP, through Wolters Kluwer Health from our own University of Washington Health Sciences Library, accessible here http://ovidsp.tx.ovid.com.offcampus.lib.washington.edu/sp-3.14.0b/ovidweb.cgi?QS2=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.

This was the most comprehensive information I could find regarding nursing care of chronic kidney diseases. It addresses all symptoms and complaints, with educational nursing care and more complex medical treatments.